Injection of intravitreal bevacizumab (Avastin) as a preoperative adjunct before vitrectomy surgery in the treatment of severe proliferative diabetic retinopathy (PDR)

Abstract

IVB administered prior to vitrectomy was well tolerated and reduced active neovascularization, thus facilitating PPV.

Surgical management of the late complications of proliferative diabetic retinopathy

“…32,33 More recently, intravitreal anti-VEGF therapy with bevacizumab administered 1-2 weeks pre-operatively has been reported to provide some benefit. [34][35][36] Early vitreous cavity haemorrhages usually clear spontaneously within 2-6 weeks without requiring further intervention.…”

“…Intravitreal bevacizumab administered 1-2 weeks pre-operatively has been reported to facilitate surgical dissection of fibrovascular membranes in eyes with severe active PDR. 35,36,[65][66][67] The risk of recurrent vitreous cavity haemorrhage may also be reduced by this treatment. 34 However, there is a potential adverse effect because fibrovascular membrane contraction can lead to rapid development or progression of tractional retinal detachment.…”

Bevacizumab prior to vitrectomy for diabetic traction retinal detachment

“…This vascular endothelial growth factor inhibitor has been reported to decrease intraoperative hemorrhage and facilitate fibrovascular membrane dissection, [3][4][5][6][7][8][9][10][11][12] and reduce postoperative vitreous hemorrhage (VH) rates. 9,[12][13][14] However, these studies were limited by relatively small numbers, heterogeneous retinal pathology (TRD and VH were studied together), and varying surgical techniques (multiple surgeons and multiple gauge vitrectomies).…”

Antiangiogenic drugs and advanced proliferative diabetic retinopathy

“…Bevacizumab has been used preoperatively as an adjuvant in vitrectomy in patients with TRD, vitreal hemorrhage, mixed TRD, active fibrovascular proliferation (FVP) (3,(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) , and neovascular glaucoma (31) (Table 1). Also, a pilot study of bevacizumab injected immediately after vitrectomy for vitreous hemorrhage was conducted (32) .…”